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Safety and Efficacy of Imatinib Versus Interferon-α Plus Cytarabine in Patients With Newly Diagnosed Philadelphia Chromosome Positive Chronic Myelogenous Leukemia

A Phase III Study of STI571 Versus Interferon-α (IFN-α) Combined With Cytarabine (Ara-C) in Patients With Newly Diagnosed Previously Untreated Philadelphia Chromosome Positive (Ph+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00333840
Enrollment
1106
Registered
2006-06-06
Start date
2000-06-30
Completion date
2012-03-31
Last updated
2013-10-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Myelogenous Leukemia

Keywords

CML, STI571, imatinib, interferon, interferon alpha, cytosine arabinoside, chronic myeloid leukemia, Philadelphia chromosome positive

Brief summary

The purpose of this study is to evaluate and compare the side effects and anti-leukemic benefits of imatinib with those of interferon and Ara-C for patients who have chronic myeloid leukemia (CML) in the chronic phase. Patients in this study will be randomized (1:1) to receive either interferon plus Ara-C or imatinib as initial treatment.

Interventions

imatinib supplied as 100 mg and 400 mg tablets or 100 mg capsules.

DRUGinterferon-alpha (INF-a)

interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m\^2/day.

cytarabine 20 mg/m\^2/day (max 40 mg) SC for 10 days every month.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Must have signed consent for Amendment 5 * Must have completed visit 62 of the core IRIS trial or be in follow-up * Must be on STI571 treatment * If on IFN treatment, must be willing to cross over to STI571 treatment

Exclusion criteria

* Patients who have discontinued from the study and are in follow-up * Patients who are on IFN treatment and do not want to cross over to STI571 treatment * Patients who have not consented to amendment 5 * Patients who did not complete the amendment 5 protocol Additional protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)12,24,36,48,60,72,84,96,108,120,132 and 144 monthsOverall survival was defined as the time between date of randomization and death due to any cause. The time was censored at last examination date for patients who were still being treated and at date of last contact for patients who discontinued treatment. Kaplan-Meier estimates of the percentage of participants at each time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

Secondary

MeasureTime frameDescription
Percentage of Participants With Event Free Survival Events (All Randomized Participants)144 monthsEvent-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenic Response (MCyR) confirmed * loss of Major Cytogenic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). The percentage of participants with Event Free Survival events in each category was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)12,24,36,48,60,72,84,96,108,120,132 and 144 monthsTime to progression to AP/BC is defined as the time between randomization and either of the following events on treatment: death (due to CML when reported as primary reason for discontinuation of treatment) or progression to Accelerated Phase or Blast Crisis and is censored at last examination date for patients without event. No data after discontinuation of study treatment was included. The Kaplan Meier estimates of the percentage of participants with survival without progression to AP/BC at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Percentage of Participants With Best Cytogenetic Response (First-line Treatment)144 monthsBone marrow aspirate was performed to evaluate cytogenetic results (percentage of Philadelphia chromosome positive (Ph+) metaphases) and amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % of Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.
Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)144 monthsBone marrow aspirate was performed to evaluate cytogenetic results (percentage of Ph chromosome (Ph+) containing metaphases) and the amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.
Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)12,24,36,48,60,72,84,96,108,120,132 and 144 monthsEvent-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenetic Response (MCyR) confirmed * loss of Major Cytogenetic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). Kaplan Meier estimates of the percentage of participants with Event Free Survival at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)144 monthsA serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant
Percentage of Participants With Major Molecular Response (First-line Treatment)12,24,36,48,60,72,84,96,108,120,132 and 144 monthsMajor Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
Percentage of Participants With Major Molecular Response (Second-line Treatment)12,24,36,48,60,72,84,96,108,120,132 and 144 monthsMajor Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)144 monthsA serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant

Countries

Australia, Austria, Belgium, Canada, Denmark, France, Germany, Italy, Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Imatinib (STI571)
In the first-line treatment period participants received imatinib 400 mg orally once daily in the morning. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10\^9/liter. If protocol specific criteria applied, participants were eligible to crossover to receive interferon-alpha (IFN-a) and cytarabine (ARA-C). Maximum study duration was 11.5 years.
553
IFN-a + Ara-C
In the first-line treatment period participants received interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m\^2/day. After the maximum tolerated dose of IFN-a was achieved, participants also received cytarabine (ARA-C) 20 mg/m\^2/day (max 40 mg) SC injections for 10 days every month. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10\^9/liter. If protocol specific criteria applied, participants were eligible to crossover to the second-line treatment period to receive imatinib (CSI151). IFN treatment was discontinued with protocol amendment 6. Maximum study duration was 8 years.
553
Total1,106

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
First-line Treatment PeriodAbnormal laboratory values3100
First-line Treatment PeriodAbnormal procedure2000
First-line Treatment PeriodAdministrative problems12600
First-line Treatment PeriodAdverse Event383700
First-line Treatment PeriodCrossed over to other treatment arm1436300
First-line Treatment PeriodDeath19200
First-line Treatment PeriodLost to Follow-up15600
First-line Treatment PeriodNo longer required study drug21800
First-line Treatment PeriodProtocol Violation171700
First-line Treatment PeriodSubject withdrew consent577700
First-line Treatment PeriodUnsatisfactory therapeutic effect882900
Second-line Treatment PeriodAbnormal Laboratory Values0003
Second-line Treatment PeriodAbnormal procedure0001
Second-line Treatment PeriodAdministrative problems0007
Second-line Treatment PeriodAdverse Event00334
Second-line Treatment PeriodDeath0009
Second-line Treatment PeriodLost to Follow-up0006
Second-line Treatment PeriodNo longer required study drug00114
Second-line Treatment PeriodProtocol Violation00110
Second-line Treatment PeriodSubject withdrew consent00034
Second-line Treatment PeriodUnsatisfactory therapeutic effect00970

Baseline characteristics

CharacteristicImatinib (STI571)IFN-a + Ara-CTotal
Age Continuous50.0 years51.0 years51.0 years
Sex: Female, Male
Female
211 Participants243 Participants454 Participants
Sex: Female, Male
Male
342 Participants310 Participants652 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
541 / 551531 / 53313 / 14347 / 363
serious
Total, serious adverse events
226 / 551163 / 5332 / 14160 / 363

Outcome results

Primary

Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)

Overall survival was defined as the time between date of randomization and death due to any cause. The time was censored at last examination date for patients who were still being treated and at date of last contact for patients who discontinued treatment. Kaplan-Meier estimates of the percentage of participants at each time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)12 months (n = 553, 553)98.9 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)24 months (n = 542, 512)96.0 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)36 months (n = 518, 471)92.4 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)48 months (n = 492, 441)90.4 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)60 months (n = 475, 411)89.4 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)72 months (n = 461, 388)88.2 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)84 months (n = 446, 373)86.6 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)96 months (n = 430, 358)85.4 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)108 months (n = 391, 315)84.3 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)120 months (n = 368, 299)83.3 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)132 months (n = 356, 288)82.8 Percentage of participants
Imatinib (STI571)Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)144 months (n = 250, 199)81.3 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)132 months (n = 356, 288)77.7 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)12 months (n = 553, 553)97.7 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)84 months (n = 446, 373)83.1 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)24 months (n = 542, 512)93.6 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)120 months (n = 368, 299)78.8 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)36 months (n = 518, 471)89.8 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)96 months (n = 430, 358)81.4 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)48 months (n = 492, 441)87.7 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)144 months (n = 250, 199)75.4 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)60 months (n = 475, 411)85.4 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)108 months (n = 391, 315)79.9 Percentage of participants
IFN-a + Ara-CKaplan-Meier Estimates of Overall Survival (All Randomized Participants)72 months (n = 461, 388)83.8 Percentage of participants
Secondary

Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)

Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenetic Response (MCyR) confirmed * loss of Major Cytogenetic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). Kaplan Meier estimates of the percentage of participants with Event Free Survival at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)12 months (n = 553, 553)96.6 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)24 months (n = 505, 332)89.6 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)36 months (n = 448, 263)85.3 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)60 months (n = 395, 223)83.2 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)72 months (n = 376, 207)83.0 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)84 months (n = 352, 181)82.0 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)96 months (n = 334, 166)81.0 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)108 months (n = 301, 141)79.9 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)120 months (n = 269, 130)79.6 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)132 months (n = 257, 124)79.6 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)48 months (n = 415, 241)83.9 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)144 months (n = 143, 76)79.6 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)48 months (n = 415, 241)63.7 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)12 months (n = 553, 553)79.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)96 months (n = 334, 166)58.3 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)24 months (n = 505, 332)70.0 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)132 months (n = 257, 124)56.6 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)36 months (n = 448, 263)67.0 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)108 months (n = 301, 141)56.6 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)60 months (n = 395, 223)61.9 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)144 months (n = 143, 76)51.8 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)72 months (n = 376, 207)60.1 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)120 months (n = 269, 130)56.6 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Event Free Survival (All Randomized Participants)84 months (n = 352, 181)59.0 Percentage of participants
Secondary

Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)

Time to progression to AP/BC is defined as the time between randomization and either of the following events on treatment: death (due to CML when reported as primary reason for discontinuation of treatment) or progression to Accelerated Phase or Blast Crisis and is censored at last examination date for patients without event. No data after discontinuation of study treatment was included. The Kaplan Meier estimates of the percentage of participants with survival without progression to AP/BC at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)12 months (n = 553, 553)98.5 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)24 months (n = 513, 388)95.7 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)36 months (n = 461, 337)94.0 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)48 months (n = 431, 311)93.1 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)60 months (n = 409, 289 )92.7 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)72 months (n = 384, 265)92.7 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)84 months (n = 358, 236)92.7 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)96 months (n = 338, 220)92.4 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)108 months (n = 305, 189)92.1 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)120 months (n = 272, 175)92.1 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)132 months (n = 259, 165)92.1 Percentage of participants
Imatinib (STI571)Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)144 months (n = 145, 94)92.1 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)132 months (n = 259, 165)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)12 months (n = 553, 553)92.9 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)84 months (n = 358, 236)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)24 months (n = 513, 388)90.0 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)120 months (n = 272, 175)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)36 months (n = 461, 337)87.9 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)96 months (n = 338, 220)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)48 months (n = 431, 311)84.7 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)144 months (n = 145, 94)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)60 months (n = 409, 289 )83.5 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)108 months (n = 305, 189)82.4 Percentage of participants
IFN-a + Ara-CKaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)72 months (n = 384, 265)83.1 Percentage of participants
Secondary

Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)

A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant

Time frame: 144 months

Population: Safety Population included all randomized participants who received study drug.

ArmMeasureValue (NUMBER)
Imatinib (STI571)Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)226 Participants
IFN-a + Ara-CNumber of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)163 Participants
Secondary

Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)

A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant

Time frame: 144 months

Population: Safety Population included all randomized participants who received study drug.

ArmMeasureValue (NUMBER)
Imatinib (STI571)Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)2 Participants
IFN-a + Ara-CNumber of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)160 Participants
Secondary

Percentage of Participants With Best Cytogenetic Response (First-line Treatment)

Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Philadelphia chromosome positive (Ph+) metaphases) and amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % of Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.

Time frame: 144 months

Population: Intent-to-treat participants included all randomized participants.

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (First-line Treatment)Major Cytogenic Response89.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (First-line Treatment)Complete Cytogenic Response82.8 Percentage of participants
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (First-line Treatment)Partial Cytogenic Response6.1 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (First-line Treatment)Major Cytogenic Response23.3 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (First-line Treatment)Complete Cytogenic Response11.6 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (First-line Treatment)Partial Cytogenic Response11.8 Percentage of participants
Secondary

Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)

Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Ph chromosome (Ph+) containing metaphases) and the amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.

Time frame: 144 months

Population: Intent-to-treat participants included all randomized participants.

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)Partial Cytogenic Response7.1 Percentage of participants
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)Major Cytogenic Response14.3 Percentage of participants
Imatinib (STI571)Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)Complete Cytogenic Response7.1 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (Second-line Treatment)Complete Cytogenic Response81.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (Second-line Treatment)Partial Cytogenic Response5.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Best Cytogenetic Response (Second-line Treatment)Major Cytogenic Response86.0 Percentage of participants
Secondary

Percentage of Participants With Event Free Survival Events (All Randomized Participants)

Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenic Response (MCyR) confirmed * loss of Major Cytogenic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). The percentage of participants with Event Free Survival events in each category was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

Time frame: 144 months

Population: Intent-to-treat population included all randomized participants.

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of MCyR (confirmed)4.2 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Participants with events17.9 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of MCyR (unconfirmed)0.9 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Progression to AP or BC6.9 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Death3.1 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of CHR2.7 Percentage of participants
Imatinib (STI571)Percentage of Participants With Event Free Survival Events (All Randomized Participants)Increase of WBC0.2 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of CHR7.6 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of MCyR (unconfirmed)1.1 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Increase of WBC3.4 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Death1.8 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Participants with events32.2 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Progression to AP or BC12.8 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Event Free Survival Events (All Randomized Participants)Loss of MCyR (confirmed)5.4 Percentage of participants
Secondary

Percentage of Participants With Major Molecular Response (First-line Treatment)

Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.

Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Population: Intent-to-treat population included all randomized participants.

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)12 months (n= 305, 83)50.2 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)24 months (n= 102, 12)69.6 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)36 months (n= 68, 7)76.5 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)48 months (n= 305, 12)77.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)60 months (n= 316, 10)88.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)72 months (n= 292, 9)88.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)84 months (n= 247, 8)91.9 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)96 months (n= 228, 4)92.5 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)108 months (n= 233, 0)93.6 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)120 months (n= 204, 0)93.1 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)132 months (n= 168, 0)92.3 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (First-line Treatment)144 months (n= 1, 0)100.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)132 months (n= 168, 0)NA Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)12 months (n= 305, 83)9.6 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)84 months (n= 247, 8)87.5 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)24 months (n= 102, 12)25.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)120 months (n= 204, 0)NA Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)36 months (n= 68, 7)28.6 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)96 months (n= 228, 4)100.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)48 months (n= 305, 12)58.3 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)144 months (n= 1, 0)NA Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)60 months (n= 316, 10)100.0 Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)108 months (n= 233, 0)NA Percentage of participants
IFN-a + Ara-CPercentage of Participants With Major Molecular Response (First-line Treatment)72 months (n= 292, 9)88.9 Percentage of participants
Secondary

Percentage of Participants With Major Molecular Response (Second-line Treatment)

Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.

Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Population: Intent-to-treat population included all randomized participants. No participants in the imatinib to IFN-a + Ara-C arm were available for testing.

ArmMeasureGroupValue (NUMBER)
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)12 months (n = 86)51.2 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)24 months (n = 62)69.4 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)36 months (n = 130)78.5 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)48 months (n = 216)81.9 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)60 months (n = 174)86.2 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)72 months (n = 146)91.1 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)84 months (n = 139)86.3 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)96 months (n = 138)87.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)108 months (n = 120)90.0 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)120 months (n = 84)85.7 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)132 months (n = 31)90.3 Percentage of participants
Imatinib (STI571)Percentage of Participants With Major Molecular Response (Second-line Treatment)144 monthsNA Percentage of participants

Source: ClinicalTrials.gov · Data processed: Apr 5, 2026